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An American physician's foray into Scandinavian healthcare.

https://arctichealth.org/en/permalink/ahliterature275731
Source
Scand J Public Health. 2016 May;44(3):225-7
Publication Type
Article
Date
May-2016
Author
Robert Gendler
Source
Scand J Public Health. 2016 May;44(3):225-7
Date
May-2016
Language
English
Publication Type
Article
Keywords
Finland
Health Care Costs - statistics & numerical data
Humans
Medical Tourism
Patient Acceptance of Health Care
Physicians - psychology
Tendinopathy - surgery
United States
Abstract
The article describes the experience of the author, an American Physician, seeking care for an uncommon orthopedic condition. Unable to find adequate treatment in the United States, the author traveled to Finland for surgical treatment.
PubMed ID
26879080 View in PubMed
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An industry perspective on Canadian patients' involvement in medical tourism: implications for public health.

https://arctichealth.org/en/permalink/ahliterature134048
Source
BMC Public Health. 2011;11:416
Publication Type
Article
Date
2011
Author
Rory Johnston
Valorie A Crooks
Krystyna Adams
Jeremy Snyder
Paul Kingsbury
Author Affiliation
Department of Geography, Simon Fraser University, Burnaby, BC V5A 1S6, Canada. rrj1@sfu.ca
Source
BMC Public Health. 2011;11:416
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Canada
Female
Humans
Industry
Interviews as Topic
Male
Medical Tourism
Middle Aged
Patient Participation
Public Health
Abstract
The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health.
Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection.
Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients.
No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public health response to medical tourism and its effects should be coupled with a clear understanding that medical tourism is a highly diverse practice. This response must also acknowledge facilitators as important stakeholders in medical tourism.
Notes
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PubMed ID
21627830 View in PubMed
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Source
Rev Med Suisse. 2011 Jun 1;7(297):1226-7
Publication Type
Article
Date
Jun-1-2011

Arctic Council Second Ministerial Meeting, Barrow, Alaska, October 10-13, 2000

https://arctichealth.org/en/permalink/ahliterature100818
Source
Documents from the Second Ministerial Meeting in Barrow, Alaska
Date
2000
  1 document  
Source
Documents from the Second Ministerial Meeting in Barrow, Alaska
Date
2000
Language
English
Geographic Location
Multi-National
Digital File Format
Text - PDF
Physical Holding
University of Alaska Anchorage
Keywords
ACAP
ACIA
AMAP
Arctic Telemedicine Project
Barrow Declaration
CAFF
Capacity building
Children and youth health indicators
Climate change
EPPR
Heavy metals
Marine pollution
PAME
PCB
POPs
Sustainable Development Working Group (SDWG)
Tourism
Documents

ArcticCouncilBarrow2000.pdf

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Beyond "medical tourism": Canadian companies marketing medical travel.

https://arctichealth.org/en/permalink/ahliterature123398
Source
Global Health. 2012;8:16
Publication Type
Article
Date
2012
Author
Leigh Turner
Author Affiliation
Center for Bioethics, School of Public Health, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. turne462@umn.edu
Source
Global Health. 2012;8:16
Date
2012
Language
English
Publication Type
Article
Keywords
Canada
Data Collection
Health Services Accessibility
Humans
Internet
Marketing of Health Services
Medical Tourism
Quality of Health Care
Abstract
Despite having access to medically necessary care available through publicly funded provincial health care systems, some Canadians travel for treatment provided at international medical facilities as well as for-profit clinics found in several Canadian provinces. Canadians travel abroad for orthopaedic surgery, bariatric surgery, ophthalmologic surgery, stem cell injections, "Liberation therapy" for multiple sclerosis, and additional interventions. Both responding to public interest in medical travel and playing an important part in promoting the notion of a global marketplace for health services, many Canadian companies market medical travel.
Research began with the goal of locating all medical tourism companies based in Canada. Various strategies were used to find such businesses. During the search process it became apparent that many Canadian business promoting medical travel are not medical tourism companies. To the contrary, numerous types of businesses promote medical travel. Once businesses promoting medical travel were identified, content analysis was used to extract information from company websites. Company websites were analyzed to establish: 1) where in Canada these businesses are located; 2) the destination countries and health care facilities that they market; 3) the medical procedures they promote; 4) core marketing messages; and 5) whether businesses market air travel, hotel accommodations, and holiday tours in addition to medical procedures.
Searches conducted from 2006 to 2011 resulted in identification of thirty-five Canadian businesses currently marketing various kinds of medical travel. The research project began with what seemed to be the straightforward goal of establishing how many medical tourism companies are based in Canada. Refinement of categories resulted in the identification of eighteen businesses fitting the category of what most researchers would identify as medical tourism companies. Seven other businesses market regional, cross-border health services available in the United States and intranational travel to clinics in Canada. In contrast to medical tourism companies, they do not market holiday tours in addition to medical care. Two companies occupy a narrow market niche and promote testing for CCSVI and "Liberation therapy" for multiple sclerosis. Three additional companies offer bariatric surgery and cosmetic surgery at facilities in Mexico. Four businesses offer health insurance products intended to cover the cost of obtaining privately financed health care in the U.S. These businesses also help their clients arrange treatment beyond Canada's borders. Finally, one medical travel company based in Canada markets health services primarily to U.S. citizens.
This article uses content analysis of websites of Canadian companies marketing medical travel to provide insight into Canada's medical travel industry. The article reveals a complex marketplace with different types of companies taking distinct approaches to marketing medical travel.
Notes
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Cites: BMC Public Health. 2011;11:41621627830
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Cites: CMAJ. 2001 Mar 20;164(6):825-3011276552
PubMed ID
22703873 View in PubMed
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Canadian family doctors' roles and responsibilities toward outbound medical tourists: "Our true role is ... within the confines of our system".

https://arctichealth.org/en/permalink/ahliterature256910
Source
Can Fam Physician. 2013 Dec;59(12):1314-9
Publication Type
Article
Date
Dec-2013
Author
Rory Johnston
Valorie A Crooks
Jeremy Snyder
Shafik Dharamsi
Author Affiliation
Simon Fraser University, Geography, 8888 University Dr, Burnaby, BC V5A 1S6. rrj1@sfu.ca.
Source
Can Fam Physician. 2013 Dec;59(12):1314-9
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Aftercare
Attitude of Health Personnel
British Columbia
Continuity of Patient Care
Family Practice
Focus Groups
Humans
Medical Tourism
Patient Care Planning
Physician's Role
Abstract
To explore how Canadian family doctors understand their roles and responsibilities toward patients who seek health care abroad.
Six focus groups were held with family doctors across British Columbia to explore their experiences with and perspectives on outbound medical tourism. Focus groups were digitally recorded, transcribed, and subsequently thematically coded to discover common issues and themes across the entire data set.
Focus groups were held with family doctors in 6 cities in British Columbia that provided representation from all provincial health authorities and a range of urban contexts.
A total of 22 currently practising family doctors participated across the 6 focus groups, with groups ranging in size from 2 to 6 participants (average 4 participants).
Thematic analysis of the transcripts identified cross-cutting themes that emerged across the 6 focus groups.
Participants reported that medical tourism threatened patients' continuity of care. Informational continuity is disrupted before patients go abroad because patients regularly omit family doctors from preoperative planning and upon return home when patients lack complete or translated medical reports. Participants believed that their responsibilities to patients resumed once the patients had returned home from care abroad, but were worried about not being able to provide adequate follow-up care. Participants were also concerned about bearing legal liability toward patients should they be asked to clinically support treatments started abroad.
Medical tourism poses challenges to Canadian family doctors when trying to reconcile their traditional roles and responsibilities with the novel demands of private out-of-country care pursued by their patients. Guidance from professional bodies regarding physicians' responsibilities to Canadian medical tourists is currently lacking. Developing these supports would help address challenges faced in clinical practice.
Notes
Cites: Maturitas. 2010 May;66(1):27-3220185254
Cites: J Med Ethics. 2010 May;36(5):297-30120439336
Cites: Open Med. 2011;5(3):e139-4822046228
Cites: Can Fam Physician. 2007 Oct;53(10):1639-41, 1646-817934018
Cites: J Law Med Ethics. 2012 Spring;40(1):122-3422458467
Cites: J Adv Nurs. 1998 Aug;28(2):345-529725732
Cites: Asia Pac Viewp. 2011;52(3):247-5922216474
PubMed ID
24336547 View in PubMed
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Climate change and tourism adaptation in Northern Sweden.

https://arctichealth.org/en/permalink/ahliterature297050
Source
Arctic Summer College. Fellow Paper. 6 p.
Publication Type
Report
Date
2015
! Arctic Summer College 2015 ! Climate Change and Tourism Adaptation in Northern Sweden ! ! ! ! ! ! ! ! ! ! ! ! ! ! Alix VARNAJOT University of Versailles, France University of Umeå, Sweden ! ! ! On the way to Arjeplog… Cdts: Alix Varnajot, 2015 Abstract As a climate
  1 document  
Author
Varnajot, Alix
Source
Arctic Summer College. Fellow Paper. 6 p.
Date
2015
Language
English
Geographic Location
Sweden
Publication Type
Report
File Size
485227
Keywords
Tourism
Climate change
Abstract
As a climate-dependent and nature based industry, tourism is closely linked to climate change. In Arctic and dub-Arctic regions like in northern Sweden, changing climate is synonym of both chalenges and opportunities for tourism professionals. This study in and around the Jokkmokk and Arjeplog settlements, where tourism professionals were interviewed, allow us to compare scholar projections and informants field experiences. This study also aim to determine how the tourism professionals community feel, face and adapt to climate change. In northern Sweden, climate change does not represent a fatality for tourism professionals. Challenges brought by changing climate seems surmontable, and new opportunities will appear during summers. However, climate change will bring close socio-cultural, economic and physical limits for societies in the two northernmost Swedish counties of Västerbotten and Norrbotten.
Documents

ASC-Paper_Varnajot_Alix.pdf

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Cost analysis of establishing dialysis facilities for the treatment of chronic renal failure in Greenland.

https://arctichealth.org/en/permalink/ahliterature138966
Source
Int J Circumpolar Health. 2010 Dec;69(5):470-9
Publication Type
Article
Date
Dec-2010
Author
Christian Kronborg
Trine Kjær
Mickael Bech
Author Affiliation
University of Southern Denmark, Institute of Public Health, Health Economics Research Unit, J.B. Winsløws Vej 9, Odense, Denmark. cka@sam.sdu.dk
Source
Int J Circumpolar Health. 2010 Dec;69(5):470-9
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Costs and Cost Analysis - methods
Greenland
Health Services - economics
Humans
Kidney Failure, Chronic - therapy
Medical Tourism
Renal Dialysis
Abstract
At present there are no facilities offering treatment for chronic renal failure with dialysis in Greenland. Patients in need of treatment must go to Denmark. It has been proposed that treatment facilities should be established at Dronning Ingrids Hospital in Nuuk, Greenland. The objective of this study is to explore the costs of such an alternative compared with the situation today.
The costs of establishing dialysis facilities in Nuuk, Greenland, and providing dialysis for Greenlandic patients were compared with the costs of the current way of managing dialysis for Greenlandic patients in need of treatment. Data for the study were collected from publicly available statistics, from Dronning Ingrids Hospital in Nuuk and from Rigshospitalet in Copenhagen.
The actual number of patients in dialysis was found to be lower than expected. Based on Danish prevalence statistics, it was expected that about 27 persons in Greenland would be in dialysis each year. Over a time horizon of 10 years, the additional costs of establishing and offering dialysis treatment in Nuuk were expected to amount to an average of 1.4 million Danish kroner (€190,000) per year compared with the current treatment costs. Results were sensitive to the demand for dialysis treatment among people in need of treatment. If all patients in need of dialysis were treated, the additional costs of establishing dialysis facilities and providing treatment in Nuuk were estimated to about 7 million Danish Kroner (€930,000) per year compared with the status quo.
Changes in the demand for dialysis treatment may influence the cost of establishing treatment facilities in Nuuk.
PubMed ID
21118637 View in PubMed
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The cost of bariatric medical tourism on the Canadian healthcare system.

https://arctichealth.org/en/permalink/ahliterature104354
Source
Am J Surg. 2014 May;207(5):743-6; discussion 746-7
Publication Type
Article
Date
May-2014
Author
Caroline E Sheppard
Erica L W Lester
Shahzeer Karmali
Christopher J de Gara
Daniel W Birch
Author Affiliation
Centre for the Advancement of Minimally Invasive Surgery, Room No. 502 CSC, 10240 Kingsway Avenue, Royal Alexandra Hospital, Edmonton, Alberta T5H 3V9, Canada; University of Alberta, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, Alberta T6G 1C9, Canada.
Source
Am J Surg. 2014 May;207(5):743-6; discussion 746-7
Date
May-2014
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery - economics
Canada
Female
Health Care Costs - statistics & numerical data
Humans
Male
Medical Tourism - economics
Middle Aged
Postoperative Care - economics
Postoperative Complications - economics - therapy
Abstract
Medical tourists are defined as individuals who intentionally travel from their home province/country to receive medical care. Minimal literature exists on the cost of postoperative care and complications for medical tourists. The costs associated with these patients were reviewed.
Between February 2009 and June 2013, 62 patients were determined to be medical tourists. Patients were included if their initial surgery was performed between January 2003 and June 2013. A chart review was performed to identify intervention costs sustained upon their return.
Conservatively, the costs of length of stay (n = 657, $1,433,673.00), operative procedures (n = 110, $148,924.30), investigations (n = 700, $214,499.06), blood work (n = 357, $19,656.90), and health professionals' time (n = 76, $17,414.87) were summated to the total cost of $1.8 million CAD.
The absolute denominator of patients who go abroad for bariatric surgery is unknown. Despite this, a substantial cost is incurred because of medical tourism. Future investigations will analyze the cost effectiveness of bariatric surgery conducted abroad compared with local treatment.
PubMed ID
24791638 View in PubMed
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"Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

https://arctichealth.org/en/permalink/ahliterature257233
Source
BMC Med Ethics. 2013;14:37
Publication Type
Article
Date
2013
Author
Jeremy Snyder
Valorie A Crooks
Rory Johnston
Shafik Dharamsi
Author Affiliation
Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada. jcs12@sfu.ca.
Source
BMC Med Ethics. 2013;14:37
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
British Columbia
Choice Behavior - ethics
Decision Making - ethics
Ethical Analysis
Female
Focus Groups
Humans
Informed Consent - ethics - standards
Male
Medical Tourism - ethics - legislation & jurisprudence - trends
Middle Aged
Physician's Role
Physician-Patient Relations - ethics
Physicians, Family - ethics - standards - trends
Social Responsibility
Abstract
Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism.
Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance.
Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy.
Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad.
Notes
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PubMed ID
24053385 View in PubMed
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33 records – page 1 of 4.